Contributors
KEVIN C. CHUNG, MD, MS (Source: Hand Clinics)
Source: Hand Clinics - July 14, 2023 Category: Orthopaedics Source Type: research
Contents
Sonu A. Jain (Source: Hand Clinics)
Source: Hand Clinics - July 14, 2023 Category: Orthopaedics Source Type: research
Forthcoming Issues
Innovation in Upper Extremity Fracture Treatment (Source: Hand Clinics)
Source: Hand Clinics - July 14, 2023 Category: Orthopaedics Source Type: research
Role for Wrist Hemiarthroplasty in Acute Irreparable Distal Radius Fracture in the Elderly
Volar locking plates for distal radius fracture (DRF) in the elderly may show complications in the most comminuted osteoporotic cases. The authors provide criteria for DRF in elderly that may not be amenable to volar plating ( “irreparable DRF”) and review the current results of a preliminary series of wrist hemiarthroplasty for these injuries. Between 2011 and 2019, 28 wrists with acute irreparable intra-articular DRF were treated with wrist hemiarthroplasty (96% female, mean age 79 years). A total of 17 wrists with a mean follow-up of 32 months were reviewed. At follow-up, mean visual analog scale (VAS) pain was 1/...
Source: Hand Clinics - July 11, 2023 Category: Orthopaedics Authors: Guillaume Herzberg, Marion Burnier, Lyliane Ly Source Type: research
Principles and Evaluation of Bony Unions
Nonunion is a common and costly problem. Unfortunately, there is no widely agreed upon and standardized definition for nonunion. The evaluation of bony union should start with a thorough history and physical examination. The clinician should consider patient-dependent as well as patient-independent characteristics that may influence the rate of healing and evaluate the patient for physical examination findings suggestive of bony union and infection. Radiographs and clinical examination can help confirm a diagnosis of union. When the diagnosis is in doubt, however, advanced imaging modalities as well as laboratory studies c...
Source: Hand Clinics - July 11, 2023 Category: Orthopaedics Authors: Tamara D. Rozental, Ian T. Watkins Source Type: research
Managing the Extra-Articular Distal Radius Malunion
Distal radius fractures are common injuries. Satisfactory outcomes are typically achieved with appropriate nonoperative or operative treatment. A proportion of these injuries develop symptomatic malunions, which may be treated surgically with distal radius corrective osteotomy. A thorough understanding of the anatomy, biomechanics, radiographic parameters, and indications is needed to provide appropriate treatment. Factors, including surgical approach, osteotomy type, use of bone graft, fixation construct, management of associated tendon and/or nerve conditions, soft tissue contracture releases, and need for ulnar-sided pr...
Source: Hand Clinics - July 11, 2023 Category: Orthopaedics Authors: Francisco Rodriguez-Fontan, Alexander Lauder Source Type: research
Staple Technology for Fracture Fixation and Joint Arthrodesis
The use of staple technology in the upper extremity has continued to evolve with the development of shape-memory alloys (SMAs) such as Nitinol that display superelastic properties that can be exploited for persistent compression. Clinical and biomechanical studies support the use of SMA staples for upper extremity fracture fixation and joint arthrodesis. To optimize biomechanical strength and clinical outcomes, it is recommended to place two staples, if possible, at the site of interest as well as to trough the staples to prevent hardware prominence. (Source: Hand Clinics)
Source: Hand Clinics - July 1, 2023 Category: Orthopaedics Authors: Samuel L. Posey, Raymond Glenn Gaston Source Type: research
Intramedullary Nailing of Forearm Fractures
The primary goal in operative fixation of forearm fractures is to restore length, rotational stability, and maintenance of the radial bow. Plate osteosynthesis is well regarded as the gold standard of treatment though often necessitates soft tissue injury, periosteal stripping, and risk of refracture after hardware removal. While intramedullary nails have been utilized for forearm fixation since the early 1900s, technological advancements including locked intramedullary nails have lead to improved outcomes in intramedullary nail forearm fixation. In select patients, intramedullary nail fixation is an appropriate treatment ...
Source: Hand Clinics - July 1, 2023 Category: Orthopaedics Authors: William Barritt Gilbert, Mihir Jitendra Desai Source Type: research
Advances in Soft Tissue Injuries Associated with Open Fractures
Management of soft tissue injury is a key component in the overall treatment of upper extremity fractures. Hand surgeons must rely on their armamentarium for treating soft tissue deficits for functional outcomes. Understanding the role of fracture fixation and wound adjuncts, including negative pressure wound therapy and dermal regenerative templates, is the keys to success. In addition, detailed knowledge of local and free tissue options is essential for hand reconstruction. (Source: Hand Clinics)
Source: Hand Clinics - June 28, 2023 Category: Orthopaedics Authors: Andrew W. Hollins, Suhail K. Mithani Source Type: research
Arthroscopic-Assisted Fracture Treatment in the Wrist
Wrist arthroscopy in the setting of wrist fracture affords direct visualization of reduction and identification of associated cartilage and soft tissue injuries. Further, mitigating soft tissue insult in the setting of perilunate injuries may decrease postoperative pain and stiffness while attaining outcomes equivalent to open techniques in appropriately selected patients. Technical proficiency of the surgeon continues to be a limitation of the technique. Randomized controlled studies are needed to better understand outcomes. (Source: Hand Clinics)
Source: Hand Clinics - June 26, 2023 Category: Orthopaedics Authors: Jeffrey Yao, Nathaniel Fogel Source Type: research
Arthroscopic-Assisted Fracture Fixation About the Elbow
Arthroscopic-assisted fracture fixation can be used for some adult elbow fractures. In particular, for articular fractures of the anterior elbow (coronoid/capitellum), elbow arthroscopy can provide excellent visualization of fracture fragments using a less invasive surgical exposure. Meticulous adherence to safe techniques and utilization of specialized equipment can help maximize safety and facilitate reproducible surgical results. (Source: Hand Clinics)
Source: Hand Clinics - June 26, 2023 Category: Orthopaedics Authors: Abhiram R. Bhashyam, Neal Chen Source Type: research
Innovations in Small Joint Arthroscopy
With advancements in surgical instrumentation and techniques, the role of arthroscopic and arthroscopic-assisted surgical procedures is ever-growing. Arthroscopy offers direct, magnified visualization of pathology and reductions and is more accurate than relying on intraoperative fluoroscopy alone. It also minimizes soft tissue stripping, which is of particular importance to smaller fracture fragments whose vascularity is precarious and can be injured through open approaches. (Source: Hand Clinics)
Source: Hand Clinics - June 20, 2023 Category: Orthopaedics Authors: Joshua J. Meaike, Sanjeev Kakar Source Type: research
Proximal Interphalangeal Joint Fractures
There are numerous operative and nonoperative options for the management of proximal interphalangeal joint fractures and fracture dislocations. The treatment of choice should be guided by the fracture pattern and joint stability. The authors highlight a contemporary option for open reduction and internal fixation techniques, but all the techniques presented are viable options under the right circumstances. It is also important to set patient expectations as most of these patients will note post-injury stiffness and potential functional limitations. (Source: Hand Clinics)
Source: Hand Clinics - June 20, 2023 Category: Orthopaedics Authors: Jeremy E. Raducha, Tyler S. Pidgeon Source Type: research
Rethinking Scaphoid Fixation
Scaphoid fixation, whether for acute injuries or nonunion, is made challenging by the small and intra-articular nature of the most commonly fractured carpal bone. The purpose of this article is to review the techniques to simplify scaphoid fixation and to optimize healing and early return to activity. (Source: Hand Clinics)
Source: Hand Clinics - June 20, 2023 Category: Orthopaedics Authors: Jill Putnam Source Type: research
Compression Neuropathies
This article describes the clinical categorization of secondary carpal tunnel syndrome and cubital tunnel syndrome, intraoperative principles of revision surgery and treatment options that are currently available. (Source: Hand Clinics)
Source: Hand Clinics - May 31, 2023 Category: Orthopaedics Authors: Tiam M. Saffari, Amy M. Moore, Ryan W. Schmucker Source Type: research
